The aim of this study was to compare the physiological effects of an individually adjusted outpatient group training programme to the standardized recommendations of walking in elderly patients (>65 years) discharged after an acute coronary episode. In all, 101 patients, 20 women and 81 men, aged 65-84 (mean 71) years, were randomized either to a supervised outpatient group training programme during three months (n = 50) or to a control group (n = 51). Exercise tolerance increased from 104 watts to 122 watts (p < 0.001) in the training group and from 102 watts to 105 watts (n.s.) in the control group. Self-estimated level of physical activity was higher in the patients in the training group than in the control group (p < 0.001), as was graded well-being (p < 0.05). Organized aerobic group training can easily be performed in elderly patients after acute coronary syndrome, with results of improved exercise tolerance and a higher self graded well-being.